Active NPI
Jennifer Lynn Souba, LSW
- Clinical Social Worker
- Reno, NV
National Provider Identifier
1730719600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8389-S
- Practice address
- 3690 Grant Dr Ste I
Reno, NV 89509-5360 - Phone
- (775) 386-8755
- NPI assigned
- Jan 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8389-S | NV | Primary |
Addresses
Primary practice location
3690 Grant Dr Ste I
Reno, NV 89509-5360
Mailing address
6155 Plumas St Apt 209
Reno, NV 89519-6043
Phone (775) 515-5137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346717725 | Medicaid | NV |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8389-S | NV | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Step LLC | Current | Accepting new patients |
Locations
3690 Grant Dr
Ste I
Reno, NV 89509
Phone (775) 386-8755
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Reno, NV
- NPI 1699536367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1579478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579478400000",
"number": "1730719600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6155 PLUMAS ST APT 209",
"city": "RENO",
"state": "NV",
"postal_code": "895196043",
"telephone_number": "775-515-5137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3690 GRANT DR STE I",
"city": "RENO",
"state": "NV",
"postal_code": "895095360",
"telephone_number": "775-386-8755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUBA",
"first_name": "JENNIFER",
"middle_name": "LYNN",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-01-20",
"last_updated": "2020-01-20",
"certification_date": "2020-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "8389-S",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1346717725",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.